Intraocular pressure elevation after cataract surgery and its prevention by oral acetazolamide in eyes with pseudoexfoliation syndrome

Abstract

To examine whether intraocular pressure (IOP) increases immediately after cataract surgery in eyes with pseudoexfoliation (PXF) syndrome and to assess whether orally administered acetazolamide can prevent the IOP elevation. Hayashi Eye Hospital, Fukuoka, Japan. Prospective case series. Patients with PXF syndrome scheduled for phacoemulsification were randomly assigned to 1 of 3 groups: (1) oral acetazolamide administered 1hour preoperatively (preoperative administration group), (2) administered 3hours postoperatively (postoperative administration group), and (3) not administered (no administration group). The IOP was measured using a rebound tonometer 1hour preoperatively, upon completion of surgery, and at 1, 3, 5, 7, and 24hours postoperatively. The study comprised 96 patients (96 eyes). The mean IOP increased at 3, 5, and 7hours postoperatively in all groups. At 1hour and 3hours postoperatively, the IOP was significantly lower in the preoperative administration group than in the postoperative group and no administration group (P≤.001). At 5, 7, and 24hours postoperatively, the IOP was significantly lower in the preoperative group and postoperative administration group than in the no administration group (P ≤. 045). An IOP spike higher than 25mm Hg occurred less frequently in the preoperative administration group than in the postoperative administration group and the no administration group (P=.038). Intraocular pressure increased at 3, 5, and 7hours after cataract surgery in eyes with PXF syndrome. Oral acetazolamide administered 1hour preoperatively reduced the IOP elevation throughout the 24-hour follow-up; acetazolamide administered 3hours postoperatively reduced the elevation at 5hours postoperatively and thereafter.